title: The impact of benzodiazepine use on methadone maintenance treatment outcomes.
abstract: The purposes of this study were to examine predictors of benzodiazepine use among methadone maintenance treatment patients, to determine whether baseline benzodiazepine use influenced ongoing use during methadone maintenance treatment, and to assess the effect of ongoing benzodiazepine use on treatment outcomes (i.e., opioid and cocaine use and treatment retention). A retrospective chart review of 172 methadone maintenance treatment patients (mean age = 34.6 years; standard deviation = 8.5 years; 64% male) from January 1997 to December 1999 was conducted. At baseline, 29% were "non-users" (past year) of benzodiazepine, 36% were "occasional users," and 35% were "regular/problem users." Regular/problem users were more likely to have started opioid use with prescription opioids, experienced more overdoses, and reported psychiatric comorbidity. Being female, more years of opioid use, and a history of psychiatric treatment were significant predictors of baseline benzodiazepine use. Ongoing benzodiazepine users were more likely to have opioid-positive and cocaine-positive urine screens during methadone maintenance treatment. Only ongoing cocaine use was negatively related to retention. Benzodiazepine use by methadone maintenance treatment patients is associated with a more complex clinical picture and may negatively influence treatment outcomes.
authors.affiliation: Centre for Addiction and Mental Health, Toronto, Canada. bruna_brands@hc-sc.gc.ca
authors.forename: Bruna
authors.initials: B
authors.lastname: Brands
authors.forename: Joan
authors.initials: J
authors.lastname: Blake
authors.forename: David C
authors.initials: DC
authors.lastname: Marsh
authors.forename: Beth
authors.initials: B
authors.lastname: Sproule
authors.forename: Renuka
authors.initials: R
authors.lastname: Jeyapalan
authors.forename: Selina
authors.initials: S
authors.lastname: Li
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology / Q000534:rehabilitation; D001569:Benzodiazepines; D019970:Cocaine-Related Disorders / Q000453:epidemiology* / Q000534:rehabilitation*; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology / Q000534:rehabilitation; D017831:Diagnosis, Dual (Psychiatry); D062787:Drug Overdose / Q000453:epidemiology; D005260:Female; D006556:Heroin Dependence / Q000453:epidemiology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008691:Methadone / Q000009:adverse effects / Q000627:therapeutic use*; D009294:Narcotics / Q000009:adverse effects / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000453:epidemiology* / Q000534:rehabilitation*; D010343:Patient Admission / Q000706:statistics & numerical data; D010352:Patient Dropouts / Q000706:statistics & numerical data; D011379:Prognosis; D011618:Psychotic Disorders / Q000453:epidemiology / Q000534:rehabilitation; D015813:Substance Abuse Detection / Q000706:statistics & numerical data; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000534:rehabilitation*; D013406:Suicide, Attempted / Q000706:statistics & numerical data; D016896:Treatment Outcome
chemical_list: D009294:Narcotics; D001569:Benzodiazepines; D008691:Methadone